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. 2021 Jul 19:12:720444.
doi: 10.3389/fneur.2021.720444. eCollection 2021.

Treatment Results of Geotropic and Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo in a Tertiary Dizziness Clinic

Britta D P J Maas  1 , Roeland B van Leeuwen  1 , Sylvia Masius-Olthof  1 , Peter Paul G van Benthem  2 , Tjasse D Bruintjes  1   2
Affiliations

Treatment Results of Geotropic and Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo in a Tertiary Dizziness Clinic

Britta D P J Maas et al. Front Neurol. .

Abstract

Purpose: To determine the effectiveness of our treatment protocol for geotropic and apogeotropic horizontal canal benign paroxysmal positional vertigo (h-BPPV). Methods: We retrospectively evaluated patients with newly diagnosed geotropic and apogeotropic h-BPPV who visited our clinic between July 2017 and December 2019. Patients were treated according to our treatment protocol, which was implemented in 2017. Patients with geotropic h-BPPV were preferably treated with the Gufoni maneuver. In patients with apogeotropic h-BPPV we executed the modified Gufoni maneuver to achieve conversion to the geotropic type. We looked at the number of successful treatments and the number of recurrences within 1 year. Results: We included 102 patients with h-BPPV, 62 (61%) of whom were treated for geotropic h-BPPV. The ratio of apogeotropic to geotropic h-BPPV was 0.65. After the first visit, we observed resolution of horizontal canal BPPV in 71 and 63% of the geotropic and the apogeotropic group, respectively. After the second visit, this percentage increased to 92% for geotropic h-BPPV and 78% for apogeotropic h-BPPV. After 1 year of follow-up we determined a recurrence rate of 32 and 24% for the geotropic and apogeotropic group, respectively. Conclusion: With our treatment protocol we managed to achieve high rates of symptom resolution in the geotropic and apogeotropic type of h-BPPV with acceptable recurrence rates. We observed a relatively high ratio of apogeotropic h-BPPV to geotropic h-BPPV.

Keywords: apogeotropic; benign paroxysmal positional vertigo; geotropic; horizontal; lateral; treatment.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Results of our treatment protocol and the number of recurrences for geotropic h-BPPV. (*) 14 patients received additional treatment for posterior canal BPPV. (**) 3 patients received additional treatment for posterior canal BPPV. (***) 1 patient with a suspected recurrence when contacted by telephone. The type of recurrence was not documented since this patient decided to continue treatment elsewhere.
Figure 2
Figure 2
Results of our treatment protocol and the number of recurrences for apogeotropic h-BPPV. (*) 5 patients received additional treatment for posterior canal BPPV. (**) 1 patient received additional treatment for posterior canal BPPV.
See this image and copyright information in PMC

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